Patient safety

14.12.16

Fall in number of hospital beds contributing to patient deaths

A decline in the number of hospital beds has put the NHS in England under increasing pressure and is contributing to hospital death rates, one of the UK’s leading health statisticians has revealed.

An investigation by Prof Sir Brian Jarman, emeritus professor at Imperial College School of Medicine (ICSM), has found that that the average occupancy levels for English hospitals have climbed to more than 89% and have not gone below the recommended average of 85% in almost 15 years.

The number of beds has more than halved over the last 30 years, with the figure now standing at 130,404 beds in English NHS hospitals compared to 297,364 in 1987-88, despite hospital admissions nearly doubling to more than 16 million.

Sir Brian said that doctor shortages had proved to be important contributory factors in hospital death rates but high occupancy rates are becoming an increasingly prominent variable.

“The factor that is most important in being most strongly associated with the variation of the death rates in hospitals in England, is that the more doctors per bed – that's either junior doctors, senior doctors or total doctors per bed - is associated with a lower adjusted death rate in hospital,” Sir Brian added.

Sir Brian’s statistical work on hospital mortality rates was crucial in exposing appalling standards of care by the NHS in Stafford Hospital, run by the now dissolved Mid Staffordshire NHS Foundation Trust.

The scandal was the subject of a public inquiry chaired by Sir Robert Francis QC, whose damning report in February 2013 made a series of recommendations to enforce a new duty of openness, transparency and candour amongst NHS staff.

David Bowles, the former chairman of United Lincolnshire Hospitals NHS Trust (ULHT), is leading a campaign to alert people to risks posed by high occupancy rates, claiming that patients’ rights may be jeopardised if hospitals fail to admit when they cannot cope with demand.

Bowles told the BBC that patients would suffer unless they understood their rights to a safe level of care and are given “a proper description of the risks of a hospital”.

“If a hospital is seriously over full, you are less likely to get an intensive care bed when you need it; you are less likely to go into coronary care if you need it; you are less likely to have access to diagnostic services when you need it,” Bowles said.

“You may go into the wrong kind of ward for your condition which means your complications are less likely to be picked up or you’re more likely to get hospital-acquired infections. Those risks need to be explained to patients.”

A spokeswoman for the DH acknowledged the NHS is facing greater demand than ever but insisted that hospitals are coping well.

The spokeswoman added that the government is committed to delivering a safer seven-day NHS and is investing £10bn to fund the NHS’s Five Year Forward View, a figure which was questioned last month by the UK Statistics Authority.

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